As we all know, there will be an NCLEX change format – called The Next Generation NCLEX in spring 2023 in order to emphasize the clinical judgment skill of nurses. Thus, in this article, we are going to give you an overview of this new nurse’s exam, what are the differences, and how it affects your nursing career. Now, let’s move to the main parts!

nclex change
NEXT Generation NCLEX – How does the NCLEX change?


1. When does NCLEX change format?

NCLEX exam is held by the National Council of State Boards of Nursing (NCSBN) to determine if a nursing graduate has the skills and knowledge to practice nursing. The NCSBN designed and continues to revise a solid and legally defensible examination to achieve this purpose. Ongoing NCLEX exam evaluations rely on research from entry-level nurses. The tests are then refined to keep up with the continually changing healthcare environment. As a consequence of these evaluations, the Next Generation NCLEX was created (NGN). The NCSBN is nearing the completion of research and testing. The revised exam questions and structure will not be available until 2023.


2. Why is the NCLEX change format?

The NCLEX is a test that each state uses to assess if new nursing school graduates have the knowledge and abilities required to practice nursing. The NCSBN undertakes an analysis every three years that identifies trends in healthcare. Because nurses are in charge of making judgments and healthcare is always changing, the NCLEX must appropriately assess new nurses’ knowledge and clinical critical thinking skills.

 After various study papers suggested that current clinical decision-making models may need to be updated, an NCLEX change was considered in 2009. The NCSBN cooperated on two investigations during the next six years. Evidence has shown that freshly licensed RNs, supervisors, institutions, and instructors place a high value on clinical judgment. The NCSBN investigated new testing methods in response to this data and the increased amount of medical blunders.


3. What is going to change in NCLEX Test?


3.1. NEXT Generation NCLEX: Conceptual changes

Clinical judgment is associated with 46% of all activities performed by entry-level nurses, according to the NCSBN, yet a recent study has revealed a lack of clinical judgment competence among rookie nurses. In the United States, medical mistakes are the third biggest cause of mortality, and just one-fifth of employers are happy with new nurses’ decision-making abilities. Saintsing et al. observed in 2011 that approximately half of all trainee nurses are involved in a nursing care mistake.

To address these issues, the Next Generation NCLEX change will attempt to assess clinical judgment abilities. As it researches and develops the next edition of the test, the NCSBN operationally defines “clinical judgment” as “the observable consequence of critical thinking and decision-making… an iterative method that employs nursing expertise to:

  • Examine and evaluate presenting conditions
  • Determine a top-priority client issue.
  • “Create the finest evidence-based solutions feasible to provide safe client care.”
nclex change concept
The Next Generation NCLEX will be changed in concept


3.2. NEXT Generation NCLEX: New item types

Between July 2017 and December 2018, candidates who took the NCLEX had the option of completing a unique research portion that assessed clinical judgment abilities. 85% of those who took the test chose to do so, and NCSBN used data from these candidates to justify the necessity for an exam revision and to assess the validity of new item types.

The new item types have been announced for the new NCLEX change version – NEXT Generation NCLEX

  • Extended drag-and-drop: You are required to pair items from 2 different columns or rows in order to make a correct sentence. In addition, in this new format, not all options can be used to answer the question, requiring a deeper understanding of the material to make a sound clinical judgment.
  • Cloze (drop-down): You will be asked to choose one option from a drop-down list. A case study will be presented and then your task is to give as many as six responses. The drop-down lists may be inserted inside a table, chart, or sentence, and the list can include words or phrases.
  • Matrix (grid): These questions present a scenario and client data before asking candidates to make decisions regarding the results by ticking suitable boxes in a supporting matrix.
  • Enhanced hot spot: These items also provide a scenario and customer information. To answer questions, candidates are requested to highlight certain areas of the scenario.

The NCSBN test now includes a part for further research. This, once again, does not contribute to the student’s NCLEX exam scores.

This part gathers data to aid in the development of scoring standards and the number of times students spend on each question. The special research segment changes each quarter based on the information sought by the NCSBN. There are no repercussions for failing to participate, and students are not required to study for the special research portion.

The NCSBN advises that educators implement the clinical judgment measurement paradigm in their simulation laboratories, conventionally written exams, and instructional contexts. They do not yet know how the adjustments will affect the pass rate.


3.3. NEXT Generation NCLEX: Scoring structure

A new scoring technique will also be included in the new NCLEX change version. The NCLEX items are currently graded as either all wrong or all correct. Using a scoring model that takes into consideration numerous replies allows for partial credit.

The scoring model employed is not the same as the passing standard. The passing standard distinguishes between pupils who pass and those who do not. The standard is determined by a group of nursing subject-matter experts. Experts anticipate that additional information about how this will happen and how it would affect the pass rate will become available closer to 2023.

nclex change 2023
NEXT Generation NCLEX changes the scoring structure


4. What are the impacts of NCLEX change format on the nursing curriculum? 

As institutions scurry to prepare students for the NEXT Generation NCLEX, nursing school curricula are anticipated to vary slightly. However, the NCSBN does not feel that nursing schools will need to completely overhaul their curriculum. It is only required to continue to successfully educate clinical judgment to new graduates in order to prepare them for the examination and their clinical job following licensing.

Although every nursing institution must fulfill accreditation criteria, there is considerable leeway in how ideas are taught. The NCLEX is the final requirement for a new nursing degree graduate before being licensed to practice by the state board of nursing.

The NCSBN clinical judgment measurement model (NCJMM), while comparable, does not replace the nursing process. It is a system based on evidence that assesses nursing graduates.

The NCSBN anticipates that the NCJMM will aid nursing educators in assessing clinical judgment in the classroom. It may also be utilized to create educational approaches for decision-making and critical thinking in order to improve clinical judgment.


In summary, the NCLEX change format is announced not only in the conceptual but also in the question types as well as the scoring structure. Hence, it leads to a change in the NCLEX learning process as well. Don’t worry, we are here to help. We will update the latest update information of the  NCSBN and provide the appropriate practice questions for you. Start practicing with NCLEX Practice Test now to conquer The Next Generation NCLEX